PMID: 12773064May 30, 2003Paper

Assessment of an age-adjusted warfarin initiation protocol

The Annals of Pharmacotherapy
Gregory William RobertsVaughn S Eaton

Abstract

To examine the time taken to reach a stable international normalized ratio (INR), as well as the incidence of overanticoagulation of an age-adjusted warfarin initiation protocol. Inpatients and outpatients commencing warfarin therapy at 2 teaching hospitals were dosed according to the age-adjusted protocol. Data were collected prospectively. Time to reach a stable INR of 2-3 and the number of patients experiencing an INR > or =4 during the first week of warfarin therapy. Seventy-three patients were assessed; at the completion of the 4-day titration protocol, 63% had achieved a stable INR. After an additional 2 days of empiric dosage adjustment by the attending physician, 86% of the subjects demonstrated a stable INR. Five patients (7%) experienced an INR > or =4. These patients had a nonsignificant trend toward a lower plasma albumin level compared with other patients (p = 0.057, Student's t-test). The INR-driven dose adjustments on days 3 and 4 of this protocol coped with other variables that have been shown to affect maintenance warfarin dosing. These included weight, gender, pharmacologic factors affecting clearance, and the presence of certain predesignated risk factors. The age-adjusted dosing protocol rapidly achieved a s...Continue Reading

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Citations

Apr 3, 2007·Molecular Diagnosis & Therapy·Maarten J BeinemaJacobus R B J Brouwers
Mar 25, 2008·Therapeutics and Clinical Risk Management·Gregory William Roberts, Robert Adams
Sep 1, 2005·Journal of Thrombosis and Thrombolysis·Vivian W Y LeeGregory Cheng
Jul 20, 2004·Journal of Internal Medicine·S L JacksonD M L Jupe
Dec 17, 2016·Journal of Thrombosis and Thrombolysis·Nibal ChamounMaichi T Tran
Nov 1, 2016·The Annals of Pharmacotherapy·Gregory RobertsStephen Quinn
Dec 17, 2003·The Annals of Pharmacotherapy·Daphne B Bernard
May 30, 2003·The Annals of Pharmacotherapy·William E Dager
Aug 30, 2005·Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing·Sarah EdmundsonPhyllis M Connolly
Mar 10, 2011·The Annals of Pharmacotherapy·Leanne StaffordLuigi Gaetani
Jul 31, 2004·Pharmacogenetics·Michael A HillmanJames K Burmester
Feb 9, 2011·Pharmaceutical Research·Daniel F B Wright, Stephen B Duffull
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Sep 3, 2010·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Ann K WittkowskyEdith A Nutescu
Jun 13, 2009·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Philip S WellsMarc Carrier
Feb 22, 2014·The Annals of Pharmacotherapy·Julia A MuellerNancy L Dawson
Nov 4, 2004·The Annals of Pharmacotherapy·Courtney D EckhoffNancy L Shapiro

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